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含血小板反应蛋白基序的解聚素和金属蛋白酶13与血管性血友病因子在子痫前期和HIV感染双重性中的关系

A Disintegrin and Metalloprotease with Thrombospondin Motif, Member 13, and Von Willebrand Factor in Relation to the Duality of Preeclampsia and HIV Infection.

作者信息

Naidoo Prelene, Naicker Thajasvarie

机构信息

Optics & Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, 719 Umbilo Road, Congella, Durban 4013, South Africa.

出版信息

Int J Mol Sci. 2025 Apr 25;26(9):4103. doi: 10.3390/ijms26094103.

Abstract

Normal pregnancy is associated with multiple changes in the coagulation and the fibrinolytic system. In contrast to a non-pregnant state, pregnancy is a hypercoagulable state where the level of VWF increases by 200-375%, affecting coagulation activity. Moreover, in this hypercoagulable state of pregnancy, preeclampsia is exacerbated. ADAMTS13 cleaves the bond between Tyr1605 and Met1606 in the A2 domain of VWF, thereby reducing its molecular weight. A deficiency of ADAMTS13 originates from mutations in gene or autoantibodies formed against the protease, leading to defective enzyme production. Von Willebrand protein is critical for hemostasis and thrombosis, promoting thrombus formation by mediating the adhesion of platelets and aggregation at high shear stress conditions within the vessel wall. Mutations in VWF disrupts multimer assembly, secretion and/or catabolism, thereby influencing bleeding. VWF is the primary regulator of plasma ADAMTS13 levels since even minute amounts of active ADAMTS13 protease have a significant inhibitory effect on inflammation and thrombosis. VWF is released as a result of endothelial activation brought on by HIV infection. The SARS-CoV-2 infection promotes circulating proinflammatory cytokines, increasing endothelial secretion of ultra large VWF that causes an imbalance in VWF/ADAMTS13. Raised VWF levels corresponds with greater platelet adhesiveness, promoting a thrombotic tendency in stenotic vessels, leading to increased shear stress conditions.

摘要

正常妊娠与凝血和纤维蛋白溶解系统的多种变化相关。与非妊娠状态相比,妊娠是一种高凝状态,其中血管性血友病因子(VWF)水平增加200 - 375%,影响凝血活性。此外,在这种妊娠高凝状态下,子痫前期会加重。含血小板结合蛋白基序的解聚蛋白样金属蛋白酶13(ADAMTS13)切割VWF A2结构域中Tyr1605和Met1606之间的键,从而降低其分子量。ADAMTS13缺乏源于基因突变或针对该蛋白酶形成的自身抗体,导致酶产生缺陷。血管性血友病蛋白对止血和血栓形成至关重要,通过介导血小板黏附以及在血管壁内高剪切应力条件下的聚集来促进血栓形成。VWF突变会破坏多聚体组装、分泌和/或分解代谢,从而影响出血。VWF是血浆ADAMTS13水平的主要调节因子,因为即使微量的活性ADAMTS13蛋白酶也对炎症和血栓形成有显著抑制作用。VWF是由HIV感染引起的内皮激活而释放的。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染会促进循环促炎细胞因子增加,导致内皮分泌超大VWF,从而引起VWF/ADAMTS13失衡。VWF水平升高与更高的血小板黏附性相对应,促进狭窄血管中的血栓形成倾向,导致剪切应力条件增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db53/12071684/32fc243ef743/ijms-26-04103-g004.jpg

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